CBD and Cannabis in the Treatment of Endometriosis

What is endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, often on pelvic organs such as the ovaries, fallopian tubes, bladder, and intestines. This tissue bleeds with each menstrual cycle, but the blood cannot leave the body, causing pain, inflammation, and scarring.

Symptoms and diagnosis of endometriosis

Common symptoms of endometriosis include severe menstrual pain, painful sexual intercourse, painful urination and bowel movements, and infertility. Diagnosis is usually made through laparoscopic surgery, which allows the doctor to directly see and biopsy the endometrial tissue.

The role of the endocannabinoid system

The endocannabinoid system (ECS) is a complex network of cell receptors in the human body that plays a crucial role in maintaining our body's balance and ensuring optimal function. The ECS regulates pain, immune responses, and inflammation, among other functions. Two key receptors of this system are the CB1 and CB2 receptors. In women with endometriosis, abnormal ECS functioning has been observed, which may contribute to the development and progression of the disease. Similar to cancer, endometrial cells are persistent, hard to destroy, and migrate to other parts of the body. A properly functioning endocannabinoid system should naturally induce cell death and prevent unwanted cell proliferation. However, in endometriosis, for some reason, the cells are allowed to multiply.

Researchers believe that CBD, by interacting with the endocannabinoid system and its two main receptors, CB1 and CB2, may help restore the system’s balance, reducing pain and inflammation.

CBD, cannabis & endometriosis

CBD, or cannabidiol, is one of the compounds in the cannabis plant, shown to have anti-inflammatory, pain-relieving, and neuroprotective effects. In the treatment of endometriosis, CBD is particularly promising as it may reduce pain and inflammation and prevent abnormal cell growth. Medical professionals also hold similar views regarding another important cannabis compound, THC.

THC and cell death

It is suspected that due to fewer CB1 and CB2 receptors in the endometrial tissue, the natural process of cell death may be disrupted, allowing the aberrant cells to multiply and spread. Preclinical studies show that cannabinoids targeting CB1 and CB2 receptors regulate the development of endometriosis.

A 2017 study demonstrated that activating the CB1 and CB2 receptors reduces the growth of endometrial tissue and promotes its breakdown, hence encouraging the death of endometrial cells. THC binds strongly to both CB1 and CB2 receptors, explaining why THC-containing cannabis products may be symptomatically beneficial and influence the pathological processes of endometriosis.

A recently published study examining the effects of THC on a mouse model of endometriosis found that THC not only reduces pain but also limits the formation of endometrial cysts.

Patient story and experiences

Carrie, a 29-year-old from the UK and author of "Endo Monologues" https://www.theendomonologues.com/, first noticed she was struggling more with her menstrual periods than her friends at age fourteen. Like many women facing these issues, Carrie was prescribed birth control pills, which helped initially.

“My pain started worsening in my late teens and early twenties,” Carrie recalls. “I was missing more and more university and felt like a hot knife was stabbing through my pelvis and back.”

For most endometriosis patients, pain intensifies around menstruation. “I felt chained to the bed,” says Carrie. “Taking the pill somehow shortened the pain, but it hurt to go to the bathroom, to walk, to sleep, I couldn't have sex, it simply became unbearable.”

For years, doctors didn’t take Carrie’s problem seriously and treated it as menstrual irregularities.

“They made me believe I was just overdramatizing and that the problem was all in my head. They said, ‘Oh, you know, it’s just your period, that’s how it is.’ And that swept the problem under the rug.”

In Carrie’s case, her own GP accused her of leading a loose sexual life and referred her to a sexual health clinic before laparoscopic surgery revealed stage 4 endometriosis on her ovaries, uterus, and bladder. The “wandering” endometrial tissue was eventually removed surgically.

Endometrial cells are tough and persistent; surgery only provides temporary relief and pain reduction. The tissue almost always regrows, accompanied by distressing symptoms. Along with over-the-counter painkillers, standard treatments include prescription birth control pills containing progesterone, which limit endometriosis recurrence in only about 1% of patients. (Estrogen stimulates the growth and spread of endometriosis.)

Many patients turn to self-care methods to manage unbearable pain, such as breathing techniques, yoga, stretching, and using cannabis oil. An Australian online survey of women in an endometriosis support group found that most identified cannabis oil as the most effective remedy for managing endometriosis pain.

Cannabis oil also clearly improved Carrie’s quality of life.

“I finished a bottle and wondered if it really made a difference,” she recalls. “Then when I didn’t take CBD for a week, I realized how severe the pain actually was. That’s when I told myself I had to keep taking it. On very bad days, I use a vaporizer, but I take oil daily, and I haven’t needed pain medication for almost a year now. A few times when I ran out, the pain was so bad I had to stay in bed or leave work early. Now I use it regularly, and it makes a big difference in my pain levels and mental health. It simply makes me feel better.”

Summary

Endometriosis is a serious and often painful condition that can significantly impact women’s quality of life. CBD, THC, and other cannabis compounds offer promising possibilities for alleviating symptoms and managing the disease. While more research is needed to understand the exact mechanisms and confirm long-term safety, current evidence and patient reports suggest that cannabis oil can be effective in treating endometriosis.

Which cannabis oil should I choose for endometriosis treatment?

The more cannabinoids an oil contains, the better its effect is likely to be.
Dr. Ethan Russo, director of a cannabinoid pharmaceuticals company and the doctor behind the development of Sativex and Epidolex cannabis products, states that full-spectrum cannabis preparations “are the right choice for treating endometriosis—both for symptoms, pain, and disease progression,” meaning you should choose an oil that contains not just CBD but also THC and other plant cannabinoids (CBDA, CBG, CBC, CBN).

How should I dose cannabis oil for treating endometriosis?

The dosage of cannabis or CBD oil depends on several factors. On this page: https://www.cannadolcbd.eu/hu/cbd-adagolasi-utmutato, you can find a detailed guide to help determine the right dosage for you. We recommend following the macro dosing chart in cases of severe pain.